Children's Hospital GME Annual Report Screeing Instrument

Children's Hospital Graduate Medical Education Program Annual Report

Documents and Forms

Document Name Document Type
Form 1 Children's Hospital GME Annual Report Screeing Instrument Form and Instruction
1 Hospital Fianance Staff HRSA 100-1 HRSA 100-1 FY13.xlsm Form and Instruction

Information Collection (IC) Details

IC Title:	Children's Hospital GME Annual Report Screeing Instrument	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Hospital Fianance Staff HRSA 100-1	HRSA 100-1 FY13.xlsm		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	54	-2	56
Annual IC Time Burden (Hours)	562	47	515
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.